Abstract
Iron deficiency anemia is an extra-stomach disease experienced in H. pylori carriers. Individuals with type A blood are more prone to suffering from H. pylori infection than other individuals. To clarify the molecular mechanisms underlying H. pylori-associated anemia, we collected erythrocytes from A, B, O, and AB blood donors and analyzed morphology, the number of erythrocytes with H. pylori colonies attached to them, and iron contents in erythrocytes and H. pylori (NCTC11637 and SS1 strains) by means of optical microscopy, scanning electron microscopy, and synchrotron radiation soft X-ray imaging. The number of type A erythrocytes with H. pylori attached to them was significantly higher than that of other erythrocytes (P<0.05). Far more iron distribution was observed in H. pylori bacteria using dual energy analysis near the iron L2, 3 edges by soft X-ray imaging. Iron content was significantly reduced in host erythrocytes after 4 hours of exposure to H. pylori. H. pylori are able to adhere more strongly to type A erythrocytes, and this is related to iron shift from the host to the bacteria. This may explain the reasons for refractory iron deficiency anemia and elevated susceptibility to H. pylori infection in individuals with type A blood.
Highlights
Helicobacter pylori (H. pylori) is a Gram-negative microanaerobic bacillus, which colonized the human gastric mucosa
H. pylori is a pathogen closely related to chronic gastritis, ulcers, and stomach cancer
H. pylori is divided into two different phenotypes, strains that contain vacuolating toxin (VacA) and cytotoxin-associated gene (CagA), and strains that do not
Summary
Helicobacter pylori (H. pylori) is a Gram-negative microanaerobic bacillus, which colonized the human gastric mucosa. Nakao and colleagues reported that both H. pylori infection and stomach disease are closely associated with genotypes of human ABO blood groups They demonstrated that the rates of H. pylori infection, chronic atrophic gastritis, and gastric cancer were higher in individuals with type A blood than in other individuals [8]. In order to uncover the possible mechanisms of H. pylori-related iron deficiency anemia, and of increased risk for H. pylori infection in type A individuals, we collected erythrocytes from donors in A, B, O, and AB blood groups and observed interactions between those erythrocytes and H. pylori ex vivo using optical microscopy, scanning electron microscopy, and thirdgeneration synchrotron radiation. We examined the interactions between H. pylori and human erythrocytes from ABO blood groups and to examine the distribution of iron This is the first report to assess interactions between human erythrocytes and H. pylori pathogen using optical microscopy, scanning electron microscopy, and third-generation synchrotron radiation. Our research will provide a valuable reference for study of the crucial mechanisms underlying H. pylorirelated iron deficiency anemia
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